Anxiety and the aching heart

There are four specific syndromes: functional cardiac disorders, mitral valve prolapse syndrome, hyperventilation syndrome and panic disorder. In many cases, the symptoms are very similar and reassurance is a critical aspect of treating these patients. Controversy exists as to what constitutes a diagnosis of mitral valve prolapse, but echocardiography has suggested a prevalence of about 5 per cent of the population. It is more common in young women weighing less than 50 kg (30 per cent) but as they become older they are less likely to suffer from the condition. On the other hand, in males age does not seem to make any difference. In most cases, prolapse is a benign and often silent disorder. Drug therapy has primarily focused on beta‐blockers whilst antipanic drugs are effective in panic disorder. The hyperventilation test undertaken in the doctor's office is a very useful way of explaining this condition to the patient and reassuring him of its relatively benign nature.